Provider Demographics
NPI:1235881228
Name:CARPIO, JESSICA (DC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:CARPIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4214 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1606
Mailing Address - Country:US
Mailing Address - Phone:716-675-2225
Mailing Address - Fax:716-675-2222
Practice Address - Street 1:4214 CLINTON ST
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1606
Practice Address - Country:US
Practice Address - Phone:716-675-2225
Practice Address - Fax:716-675-2222
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX013536-01111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor